Assignment: DNP Project Declaration

Assignment: DNP Project Declaration

Assignment: DNP Project Declaration

DNP Project Declaration Form

Complete this document and submit to the Unit 8 assignment Dropbox.

Student Name:                                                                                                                                                

DNP Project Title: Early Mobility in ICU

DNP Project Description: (Include responses to the questions in the assignment guidelines)

1. Brief description of the proposed DNP project idea. Please address the following:
   • What is the gap in practice or issue that needs to be resolved?
   • How will the project inform practice or resolve the clinical problem?
   • What are the proposed project interventions?
   • Describe the expected health outcomes that result from the proposed project interventions; identify how the outcomes are population-centered and measurable.
   • How will mastery of DNP competencies be evident in the project?
   • How does the project reflect a system thinking approach? Is the project grounded in evidence? Provide a brief synopsis of three sources of evidence from the literature.
2. Describe the project idea in a PICOT statement.
   

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PICOT:

Population or Problem or Patient: (Explain the population and problem);

Intervention: (Explain what you are intending to do to address the problem);

Comparison: (Explain what the alternative to your intervention is);

Outcomes: (Relevant outcomes);

Time: (Planned timeline)

Evidence to Support DNP Project: (Provide statistical evidence of the problem and a brief synopsis of three articles, within five years, from the literature that support your project idea)

Signature of DNP Student:                                                                                Date:                            

DNP Project Reviewed:                                                 Date:_________________

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DNP Project Declaration

The planned Doctor of Nursing Practice (DNP) project aims to tackle a significant deficiency in the treatment of critically ill patients in the Intensive Care Unit (ICU) – specifically, the insufficient utilization of early mobility procedures. Extended immobilization in the intensive care unit frequently results in problems, such as muscular weakness and respiratory deterioration (Schefold et al., 2020), underscoring the necessity for focused therapies. The objective of this project is to establish a well-organized early mobility program, based on proven procedures supported by research, to improve patient outcomes and alleviate the negative effects of immobility. The initiative seeks to achieve beneficial improvements in clinical practice by employing an organized and thorough approach while also demonstrating proficiency in DNP competencies.

Project Description

Gap in Practice and Issue Resolution

The current approach lacks enough acknowledgment of the influence of early mobility treatments in the ICU. This gap considerably adds to the occurrence of problems and prolongs the duration of hospital stays. The resolution strategy entails the systematic implementation and subsequent assessment of a well-organized early mobility program designed to prevent or alleviate the negative consequences of extended immobility.

Proposed Interventions

            Exploring the strategies envisioned for the project, we suggest a series of extensive interventions designed to tackle the deficiency in early mobility practices in the ICU. These comprehensive interventions involve the careful creation and execution of protocols for early mobility, which include particular activities for early movement. As part of our plan, we will perform comprehensive physical therapy exams to examine the mobility levels of patients. We aim to provide customized mobility programs specifically designed to meet the unique demands of each patient. This might involve fundamental movements such as changing positions in bed, advancing to more complex tasks like sitting on the side of the bed and eventually integrating gradual walking.

Facilitating interdisciplinary collaboration among diverse healthcare practitioners is essential for the effectiveness of therapies (Bendowska & Baum, 2023). Nurses, physical therapists, and other healthcare experts will collaborate to smoothly incorporate these initial movement exercises into the daily care regimen of ICU patients. Through this approach, we expect to not only improve the physical health of individual patients but also have a positive impact on the larger population of critically ill people in the intensive care unit.

Expected health Outcomes

We expect an array of beneficial health outcomes, such as an improvement in the functional level of patients, a decrease in problems associated with immobility, and shorter durations of stay in both the ICU and the hospital. These outcomes will not only focus on improving the well-being of individual patients but will also have a positive impact on the larger population. Furthermore, we will ensure that these results are measurable. We will have specialized tools, such as standardized mobility evaluations and patient-reported outcomes, which will enable us to measure and monitor these improvements in a precise manner.

Mastery of DNP Competencies

The core focus of this project is the proficient application of DNP competencies. Exhibiting advanced expertise requires the consideration of various crucial aspects. The use of evidence-based practice is a fundamental aspect that demonstrates the capacity to transform research findings into practical approaches for improving patient care in the ICU. The project highlights the DNP student’s ability to integrate theoretical knowledge and practical applications, bridging the gap between evidence and healthcare practice.

The ability of the DNP student to lead the implementation of a structured early mobility program is a crucial aspect of their leadership skills. This leadership extends beyond healthcare teams, integrating new protocols into established institutional processes. The project demonstrates the student’s skill in effecting change in sophisticated healthcare settings and promoting collaboration across many disciplines. Additionally, the project actively engages in advocating for policy reforms, with a focus on highlighting the DNP student’s involvement in promoting systemic improvements. The project demonstrates a dedication to improving healthcare policy and patient outcomes by actively engaging in and advocating for the adoption of early mobility protocols into institutional guidelines.

System Thinking Approach and Evidence Grounding

The project demonstrates a systems thinking approach, which systematically tackles complex health and well-being concerns within the community (Morgan et al., 2023). This approach is crucial for assessing the interrelationships among various components, promoting a comprehensive comprehension of the project’s impact. The project is grounded in evidence, with support from the literature indicating the positive impact of early mobility on patient outcomes.

Three sources of evidence from the literature include a meta-analysis by Zhang et al. (2018) that demonstrates early mobilization in ICU is safe and decreases the duration of mechanical ventilation in patients, a systematic review and meta-analysis by Zhang et al. (2019) showing that early mobilization decreases the incidence of ICU-acquired weakness, improves the functional capacity and increases the rate of discharge to home rate for patients with critical illnesses in the ICU. Furthermore, a cohort study by Escalon et al. (2020) demonstrates that early mobilization results in cost savings, increased independence and strength, and decreased readmission rates.

PICOT Statement

For critically ill patients in the ICU (Population), the implementation of a structured early mobility program (Intervention), compared to standard care without early mobility protocols (Comparison), is expected to lead to improved functional status, reduced complications related to immobility, and decreased lengths of both ICU and hospital stays (Outcomes) over the course of the ICU admission (Time).

Conclusion

In conclusion, the proposed DNP project on early mobility in the ICU offers a thorough and research-supported strategy to tackle a significant deficiency in current practices. The initiative seeks to enhance patient outcomes, minimize problems, and shorten hospital stays through the implementation of early mobility therapies.

References

Bendowska, A., & Baum, E. (2023). The significance of cooperation in interdisciplinary health care teams as perceived by Polish medical students. International Journal of Environmental Research and Public Health, 20(2), 954. https://doi.org/10.3390/ijerph20020954

Escalon, M. X., Lichtenstein, A. H., Posner, E., Spielman, L., Delgado, A., & Kolakowsky-Hayner, S. A. (2020). The Effects of Early Mobilization on Patients Requiring Extended Mechanical Ventilation Across Multiple ICUs. Critical Care Explorations, 2(6), e0119. https://doi.org/10.1097/cce.0000000000000119

Morgan, M. J., Stratford, E., Harpur, S., & Rowbotham, S. (2023). A Systems Thinking Approach for Community Health and Wellbeing. SpringerLink. https://doi.org/10.1007/s11213-023-09644-0

Schefold, J. C., Wollersheim, T., Grunow, J. J., Luedi, M. M., Z’Graggen, W. J., & Weber‐Carstens, S. (2020). Muscular weakness and muscle wasting in the critically ill. Journal of Cachexia, Sarcopenia and Muscle, 11(6), 1399–1412. https://doi.org/10.1002/jcsm.12620

Zhang, G., Zhang, K., Cui, W., Hong, Y., & Zhang, Z. (2018). The effect of early mobilization for critical ill patients requiring mechanical ventilation: a systematic review and meta-analysis. Journal of Emergency and Critical Care Medicine, 2(1), 9. https://doi.org/10.21037/jeccm.2018.01.04

Zhang, L., Hu, W., Cai, Z., Liu, J., Wu, J., Deng, Y., Yu, K., Chen, X., Zhu, L., Ma, J., & Qin, Y. (2019). Early mobilization of critically ill patients in the intensive care unit: A systematic review and meta-analysis. PLOS ONE, 14(10), e0223185. https://doi.org/10.1371/journal.pone.0223185